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2 Tests May Improve Heart Patients' Care, Studies Suggest
Date:8/22/2012

est that looks for CRP, a marker of cardiovascular disease. Carotid intima-media thickness measures the thickness of the inner lining of the carotid artery. Brachial flow-mediated dilation uses ultrasound to see how well the blood vessels in the arm work.

The study included almost 7,000 people from six centers in the United States. About 1,300 were considered intermediate risk and had complete data on all of the tests. After almost eight years of follow up, 94 people had a heart attack, were treated for chest pain, were resuscitated after cardiac arrest or died from a heart event.

A positive finding on the coronary artery calcium test translated to 2.6 times greater odds of having a heart event. Results from the ankle-brachial index indicated 21 percent lowered odds of a heart event. The high-sensitivity CRP findings indicated 28 percent higher odds of a heart event, and those with a family history of heart disease had more than double the odds of having a heart event.

The carotid intima-media thickness test and the brachial flow-mediated dilation weren't found useful in predicting heart risk in this study.

The second study, led by Dutch researcher Hester Den Ruijter, also looked at the usefulness of carotid intima-media thickness. The researchers reviewed data from 14 studies involving nearly 46,000 participants and found that the carotid intima-media thickness test was associated with a small improvement in heart disease prediction, but that the improvement was so small it's likely not to be helpful in clinical practice.

"There seems to be little information gained from [the carotid intima-media thickness test] that would alter current decision making, and it appears that the extra cost isn't justified," wrote the authors of an accompanying editorial in the same journal issue.

"On the other hand," they wrote, the "coronary artery calcium score, which did improve the [risk prediction] substantially, requires additional asse
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